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July 26, 2020: Roundup & Myth Busting

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Table of Contents

Table of Contents
Intro and Disclaimer
COVID-19 and Travel
Recent Federal Response to Protestors
Rest in Power John Lewis and C.T. Vivian
COVID-19 and Semen
COVID-19 Patient Outcomes and Hospital Size
COVID-19, Trans Workers, and Burger King
LGBTQ+ Youth Face Rejection from Families in Lockdown
Online Survey Shows Vulnerability of LGBTI Community During Pandemic
QM Public Health Crisis Round-Up Team (in no particular order):

Intro and Disclaimer

QM would like to help you make sense of information being circulated by: 1. Translating data into digestible language, 2. Dispelling misconceptions and linking to evidence, and 3. Curating relevant data, and articles on a weekly basis. Our Round Up/ Mythbusting projects are intended to help our QM family make sense of information being circulated. Taking control of our health as a queer community includes making institutional knowledge accessible to the public. 

Disclaimer: Although this information has been evaluated and determined to be accurate by Queering Medicine (QM), we at QM do not want to give the impression that we are the sole gatekeepers of medical knowledge. As a collective, QM members bring professional and personal qualifications that allow us to research and share credible knowledge. Our goals for this weekly round up and myth busting is to translate data into digestible information, dispel misinformation, and curate relevant data for the Lansing queer community. We encourage the community to question knowledge found outside of reputable sources, however, Queering Medicine will gladly help facilitate this process. If evidence or recommendations change, or any inaccuracies are found, we will correct them and explain the changes. If you have any questions about our methodology and sources, or you would like to point out any inaccuracies, please let us know!

COVID-19 and Travel

More and more people are traveling to enjoy the summer weather outdoors, to visit family and friends, or just to get away from the neighborhoods they've felt trapped in under lockdown. “Because travel increases your chances of getting infected and spreading COVID-19, staying home is the best way to protect yourself and others from getting sick,” according to the CDC. The CDC notes that air, bus, and train travel generally require being within six feet of other people (often for extended periods of time), which increases the risk of infection. Traveling by car or RV brings added risks through coming into contact with other people or surfaces touched by other people while stopping for gas, food, or bathrooms.

If you do travel, it's critical to continue to wear a mask, maintain physical distance from people outside your household, and wash your hands frequently, no matter where you go. You can become infected with COVID-19 at your destination (or en route to it), and you can spread COVID-19 when you get there (remember, people don't have to have symptoms to be infected and contagious!).

While many states in the U.S. have less strict requirements about masks and physical distancing, that doesn't mean it's safer there (in fact, it's often the opposite). If you're considering traveling to a popular destination, it may be better to reconsider. Having a large number of people in a small area, particularly when they're less likely to wear a mask and observe distancing (as has been seen at many tourist destinations, beaches, and other summer spots), may put you at far greater risk than other options, and having people from around the region or country congregate in one area significantly heightens the risk of contagious people being present and spreading the virus.

Many countries are considerably safer than the U.S. now, and some are reopening without issue, but these are generally not options for people in the United States looking to travel. The spread of COVID-19 in the U.S. is considered to be so out-of-control that most countries have banned the entry of people from the U.S. except under special circumstances. Only nine countries are currently allowing U.S. citizens to enter without significant restrictions, and most are not common tourist destinations:

  • Albania

  • Dominican Republic

  • Kosovo

  • Maldives

  • Mexico

  • North Macedonia

  • Serbia

  • Tunisia

  • Turkey

Several other countries are allowing U.S. citizens to enter with restrictions (for most, negative COVID-19 test results from the prior 1-7 days):

  • Antigua and Barbuda

  • Aruba

  • Barbados

  • Belize

  • Bermuda

  • Cambodia

  • Croatia

  • Ecuador

  • Egypt

  • French Polynesia

  • Jamaica

  • Rwanda

  • St. Barts

  • St. Lucia

  • St. Vincent and Grenadines

  • Tanzania

  • Turks and Caicos

  • Ukraine

  • United Arab Emirates

  • United Kingdom

All other countries, including most of Europe, South America, Australia, Asia, and Africa, are off-limits.

People from the U.S. looking to vacation in Canada will find that they aren't allowed to cross the border. Non-Canadians can only enter for "non-discretionary" purposes (like work, school, or immediate medical care) or to be with an immediate family member that’s a Canadian citizen or permanent resident, and they will be denied entry if they have symptoms of COVID-19. Even for those allowed in, a mandatory 14-day quarantine is required in most cases. Tourism, recreation, and entertainment are considered "discretionary" travel, and non-Canadians cannot enter the country for those reasons.

More information: 

  • "The handful of countries still welcoming US tourists":
    https://www.cnn.com/travel/article/us-international-travel-covid-19/index.html 

  • Government of Canada: “Canada-U.S. border restrictions":
    https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/latest-travel-health-advice.html#_Canada-U.S._border_restrictions_1
     

  • CDC: "Considerations for Travelers—Coronavirus in the US":
    https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-in-the-us.html

Recent Federal Response to Protestors

In recent days, federal officers have been arresting protesters in Portland, Oregon, in some cases without any identification, transporting them in unmarked vans, and detaining without due process. Peaceful protestors have also been gassed and beaten. Federal agents have been deployed to several other cities, including Chicago and Albuquerque. In Seattle, federal agents from “The Special Response Team,” operating under Customs and Border Protection, were also deployed, despite Seattle officials rejecting their presence. The Trump administration has stated they may send federal agents to Detroit, but the mayor and police chief of Detroit have both stated that they do not want the additional federal presence. 

Chad Wolf, acting head of the Department of Homeland Security, stated that there was a “distinction” between the agents deployed in Portland versus other cities, as the agents deployed in Portland were there to “protect the federal courthouse,” whereas in other cities, he states the agents are there to “protect the public from street crime.”

Leaders from all of these cities have rejected the presence of federal agents sent to interfere with protestors in their cities. While the federal government states the presence of federal agents is to protect people, activist organizations have stated that the acts are done  to suppress protests and silence voices, and have sued the federal government for their response. In Portland, Kate Brown, Governor of Oregon, stated that the use of federal agents was a “blatant abuse of power.” Many other constitutional law experts and leaders have denounced the actions in Portland, stating that these actions are well beyond the scope of federal authority, and violate constitutional rights. Oregon’s attorney general, Ellen Rosenblum, filed a lawsuit to restrict operations of federal agents in Portland, particularly with regard to the arrests of people without identification and due process. A federal judge rejected the lawsuit, but in a separate federal case involving ACLU Oregon, a judge issued a temporary restraining order barring federal agents from interfering with, arresting, or attacking journalists and legal observers. 

Protesting is a crucial way for people to voice their concerns and to bring about positive change, particularly for minorities and marginalized groups, including BIPOC and LGBTQ+ communities. The federal government’s actions are incredibly worrisome, and it is suggested that protesters plan for safety, including wearing a mask, adhering to social distancing when possible, and also developing exit plans, support systems, and techniques to mitigate harm from gas and other violent tactics from law enforcement and federal agents. This is more important than ever, as the rights that should protect you may be ignored by those sent to stop protests. 

Sources:

  • "Detroit mayor and police chief say they don't want Trump to send federal agents here":
    https://www.metrotimes.com/news-hits/archives/2020/07/21/detroit-mayor-and-police-chief-say-they-dont-want-trump-to-send-federal-agents-here 

  • "DHS Chief Says His Federal Agents Are ‘Proactively’ Arresting People In Portland":
    https://talkingpointsmemo.com/news/dhs-chief-says-his-federal-agents-are-proactively-arresting-people-in-portland 

  • "Philadelphia's Top Prosecutor Is Prepared to Arrest Federal Agents":
    https://www.bloomberg.com/news/articles/2020-07-22/philly-d-a-threatens-to-arrest-federal-agents 

  • "Constitutional law experts see federal officers’ actions in Portland as a ‘red flag’":
    https://www.pbs.org/newshour/politics/constitutional-law-experts-see-federal-officers-actions-in-portland-as-a-red-flag 

  • "Portland Federal Agents Accused of War Crimes for Destroying Medical Supplies":
    https://www.newsweek.com/portland-federal-agents-destroying-medical-supplies-1519945 

  • "Federal Agents Envelop Portland Protest, and City’s Mayor, in Tear Gas":
    https://www.nytimes.com/2020/07/23/us/portland-protest-tear-gas-mayor.html 

  • “Feds Sending Tactical Team to Seattle, Expanding Presence Beyond Portland”:
    https://www.nytimes.com/2020/07/23/us/seattle-protests-feds.html

  • “Judge Rejects Challenge to Federal Agents Targeting Portland Protestors”:
    https://www.nytimes.com/2020/07/24/us/portland-federal-jurisdiction-court-judge.html

  • "Judge refuses to issue order reining in federal agents in Portland":
    https://www.politico.com/news/2020/07/24/judge-federal-agents-portland-reject-381381

  • "Judge orders feds in Portland not to use force against journalists":
    https://www.politico.com/news/2020/07/23/judge-orders-feds-portland-force-journalists-381022 

  • “Federal Court Issues Restraining Order on Federal Agents in Portland”:
    https://www.aclu.org/press-releases/federal-court-issues-restraining-order-federal-agents-portland 

Rest in Power John Lewis and C.T. Vivian

On July 17th, two leaders of the fight for civil rights in the U.S. died: John Lewis and C.T. Vivian. Both worked alongside Martin Luther King, Jr, both were leaders of the Selma to Montgomery marches, and both received the Presidential Medal of Freedom later in life. John Lewis went on to serve in Congress for over three decades, and C.T. Vivian, helped found a variety of civil rights organizations.

More information:

  • Black Lives Matter: "Rest in Power…Rep. John Lewis and Rev. C.T. Vivian" https://blacklivesmatter.com/rest-in-power-rep-john-lewis-and-rev-c-t-vivian/

  • "The US loses two icons of the civil rights movement in one day  https://www.cnn.com/2020/07/18/us/john-lewis-ct-vivian-dead/index.html 

COVID-19 and Semen

As scientists try to understand the total changes that COVID-19 has on the body, there’s building evidence that the virus may cause damage to cells responsible for semen quality and production. Taken together, these observations translate to the possibility of COVID-19 causing infertility in severe infections; there is lacking quality data as to whether COVID-19 causes damage in mild or asymptomatic infections. It is theorized that the mechanism of action for damage to sperm-producing cells is through the accumulation of ACE2-derived protein products; the ACE2 receptor is the primary receptor responsible for COVID-19 cell entry, and is found throughout the human body, including in the reproductive tract. To what extent the virus causes irreversible damage to semen quality is not fully understood. However, viruses such as HIV, mumps, and various hepatitis strains have all been recognized as causes of infertility. Interestingly, increased ACE2 levels in biologically assigned males compared with biologically assigned female genital tracts have been suggested as a possibility for enhanced viral clearance in those with biologically assigned female genital tracts. 

COVID-19 has been linked to the possibility of sexual transmission from semen in rare circumstances, however no known cases of sexual transmission have been reported. Scientists found the presence of COVID-19 in semen samples of 15% of 38 patients (6 of 38). 4 of 6 of these patients were in the active stage of infection, and the other 2 of 6 of these patients had been in recovery for 3 days or less. Age distribution ranged from 20s to 50s. While at face value, one might question the relevance of sexual transmission in a virus that is well-known to be spread through respiratory transmission (virtually all sexual encounters involve people breathing within six feet of each other), viruses such as Zika have been suggested to be passed onto biologically-assigned women through sexual transmission. 

More Information:

  • JAMA Network: Clinical Characteristics and Results of Semen Tests Among Men with Coronavirus Disease 2019: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765654. 

  • European Urology Focus: Pathological Findings in the Testes of COVID-19 Patients: Clinical Implications:
    https://www.eu-focus.europeanurology.com/article/S2405-4569(20)30144-9/pdf.  

  • medRxiv: Delayed clearance of SARS-CoV2 in male compared to female patients: High ACE2 expression in testes suggests possible existence of gender-specific viral reservoirs:
    https://www.medrxiv.org/content/10.1101/2020.04.16.20060566v1. 

COVID-19 Patient Outcomes and Hospital Size

A study from JAMA: Internal Medicine found that smaller hospitals (less than 50 Intensive Care Unit (ICU) beds) had COVID-19 mortality rates that were three times worse than larger hospitals (50+ ICU beds). While the researchers could not definitively conclude that larger hospitals do a better job than smaller hospitals at managing COVID-19 patients who are critically ill, they did note that larger hospitals have more resources and seem to have better outcomes for patients who require specialized equipment such as mechanical ventilation. For reference, Lansing’s Sparrow Hospital is reported to have 44 ICU beds, and McLaren Greater Lansing hospital is reported to have 16 ICU beds. 

In the study, researchers concluded that race did not affect mortality outcomes in this 2000-patient study. They noted that Black patients had a higher likelihood of being admitted to the ICU, however once there, there was no observed difference in mortality rate based on race alone. Researchers did conclude that older age, obesity, cancer, and sex (being male) as risk factors. 

Sources:

  • https://www.leapfroggroup.org/hospital/profile/Sparrow+Hospital+&+Health+System

  • https://www.wbur.org/commonhealth/2020/07/15/covid-hospital-mortality-death-bigger

  • https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768602

COVID-19, Trans Workers, and Burger King

Workers at a California Burger King were on strike on Friday, July 10, in response to the company’s handling of the death of a transgender coworker earlier in the week. Ángela Martínez Gómez, who worked for the company for 15 years, had been experiencing severe symptoms consistent with COVID-19. She was allowed to work for one week despite being ill, and ultimately ended a shift early because she felt too sick to continue. She died one week later. Multiple news sites report that her coworkers are outraged that the store manager blamed her death on “injecting hormones,” reflecting a bias against transgender people, rather than naming COVID-19 as a risk to the safety of staff. Workers at the store allege that Burger King has not taken the pandemic seriously, nor has the company taken the necessary precautions to keep workers safe, including inadequate cleaning and a lack of transparency when workers become sick. Workers at the store are reporting that since Ángela’s death, at least one other coworker has become sick. During their strike on July 10, people in cars silently lined up in the drive-thru lane with flowers, signs proclaiming “Trans Lives Matter,” and made signs demanding worker safety. There is currently a California Division of Occupational Safety and Health investigation ongoing, and Burger King has released a statement that they are investigating the transphobic comments coworkers allege the manager made in response to Ángela’s death. Despite demands from staff that the store close and allow workers to quarantine with pay, the store has remained open. Ángela’s family is asking for support in transporting her body back to Oaxaca, Mexico and to support her funeral costs. Donations can be made here. Ángela’s death is a reminder that transgender BIPOC are especially vulnerable during the pandemic. According to the National Center for Transgender Equality in a survey prior to the pandemic, more than one in four transgender people have lost a job due to bias, and more than seventy-five percent have experienced discrimination in the workplace. Furthermore, the 2015 US Transgender Survey found that transgender BIPOC are more than three times as likely as the general United States population to be living in poverty. The intersection of discrimination and socioeconomic disparities trans BIPOC face put their physical and mental health at risk, making the community especially vulnerable during the pandemic. 

https://www.gofundme.com/f/in-loving-memory-of-angela. 

Sources: 

  • https://losangeles.cbslocal.com/2020/07/11/burger-king-protest-complaint-santa-monica-death/

  • https://twitter.com/msainat1/status/1281679369921077250/photo/1 

  • https://patch.com/california/santamonica/santa-monica-burger-king-worker-dies-coronavirus

  • https://twitter.com/Fightfor15LA/status/1281681328648273920

  • https://ktla.com/news/local-news/santa-monica-burger-king-employee-files-complaint-after-death-of-co-worker-with-covid-19-symptoms/

  • https://www.lgbtqnation.com/2020/07/burger-king-workers-strike-trans-employee-dies-covid-bk-blamed-hormones-death/

  • https://transequality.org/issues/employment

  • https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf

LGBTQ+ Youth Face Rejection from Families in Lockdown

It isn’t hard to believe that COVID-19 has negatively impacted the lives of many in the U.S., but for many LGBTQ+ youth, it has been particularly difficult. Universities across the country have transitioned into online learning environments in order to help stem the spread of COVID-19. Among these university policy changes is the closing of on-campus housing, leaving many students with no other choice but to return to their home communities. For LGBTQ+ students, this could mean leaving an affirming and supportive space for one that is hostile. NPR’s “Home But Not Safe” appropriately reports that “college is a life line for a lot of LGBTQ people.” It is often a space where LGBTQ+ students are able to freely express/explore their sexual and gender identities, access medical care and treatments that they previously couldn’t, and build affirming relationships. Returning home for LGBTQ+ people could mean having a parent who berates them for being LGBTQ+ or a sibling who refuses to use their pronouns. Research that focused on LGBTQ+ youths’ experiences with COVID-19 noticed a doubling in usage of online formal and informal LGBTQ+-specific support platforms such as the Trevor Project and Q Chat Space since April 2020. They’ve also noticed that most of their participants’ COVID-19-related stressors had a common theme of LGBTQ+-specific intrapersonal, interpersonal, and structural challenges from being home. The researchers concluded that many LGBTQ+ youth are facing rejection from their families during lockdown and online support and resources are becoming increasingly important in helping them cope. If you find yourself emotionally and physically isolated due to COVID-19, know that you’re not alone. There are plenty of loving and affirming online communities available for you to connect to. If you come from a place of privilege where you have an affirming home, there are plenty of ways for you to donate your time, energy, or resources to help others. It’s only a phone call or text message away.

More information:

  • https://www.npr.org/sections/health-shots/2020/05/17/856090474/home-but-not-safe-some-lgbtq-young-people-face-rejection-from-families-in-lockdo

  • Fish, Jessica N., et al. “‘I'm Kinda Stuck at Home With Unsupportive Parents Right Now’: LGBTQ Youths' Experiences With COVID-19 and the Importance of Online Support.” Journal of Adolescent Health, 2020, doi:10.1016/j.jadohealth.2020.06.002.

  • https://www.thetrevorproject.org/get-help-now/

  • http://www.glnh.org/

  • https://www.translifeline.org/

  • https://suicidepreventionlifeline.org/chat/

  • https://www.1800runaway.org/

  • https://www.rainn.org/

  • https://www.thehotline.org/

Online Survey Shows Vulnerability of LGBTI Community During Pandemic 

The results of a recent online survey show that the pandemic puts the health and economic stability of lesbian, gay, bisexual, transgender and intersex (LGBTI) people at further risk. The results of the survey, organized by UNAIDS, the LGBT+ Foundation, and researchers from the Johns Hopkins Bloomberg School of Public Health and other universities, was discussed at the opening session of the 2020 International AIDS Conference. The survey included more than 20,000 people who identify as LGBTI across 138 countries in April and May. Highlights from the survey:

  • 13% had already lost their jobs

  • 20% were anticipating losing their jobs soon

  • 47% faced economic difficulty, with 25% not being able to meet basic needs

  • 21% living with HIV had “interrupted or restricted access” to antiretroviral therapy

  • 42% living with HIV had less than one month’s supply of treatment on hand

In our May 17 Round-Up, Queering Medicine reported on data released by the Williams Institute at the UCLA School of Law that showedways in which transgender adults in the United States face increased risk from COVID-19. In the report, the Williams Institute spoke to the intersecting impacts of discrimination at work and in healthcare, poverty, underlying health conditions, and higher rates of social isolation. In combination, these reports underscore how the pandemic is disproportionately affecting an already vulnerable community. 

For more information and data from the online survey, click here.

For a full link to the Williams Institute report, click here. 

QM Public Health Crisis Round-Up Team (in no particular order): 

  • Mauricio Franco (he/him/his), M.S.- Global Medicine, Third year medical student.

  • Andrew-Huy Dang (he/him/his), Third year medical student, B.S. Microbiology.

  • Wyatt Shoemaker (he/him/his), Third year medical student.

  • Antonio Flores (he/him/his), Second year medical student, B.S. Public Health Sciences.

  • Daniel Pfau (they/them/theirs), Neuroscience PhD, Biological Sciences MS, Homeschool Teacher.

  • Francis Yang (he/him/his), M.S.-Global Medicine, First year medical student.

  • Kryssia Campos (she/her/hers), First year medical student.

  • Alessandra Daskalakis (she/her/hers): First year medical student, B.S. Biology, B.A. Comparative Literature

  • Vanessa Burnett (she/her/hers) M.P.H; Health Equity Consultant, Michigan Public Health Institute

  • Wilfredo Flores (he/him/his), M.A. Technical Communication

  • Grey L. Pierce (they/them); M.A., Cognitive Psychology; Assistant Director, Michigan State University (MSU) Usability/Accessibility Research and Consulting; Project Manager, State of the State Survey, MSU Institute for Public Policy and Social Research

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